“Let my Spirit Always Sing”: a Descriptive Study of How Four Elderly Rest Home Residents View Spirituality and Spiritual Care at the End of Life

Abstract:

Over the last twenty years spiritual care has become recognised increasingly as an important component of holistic care, care that nurtures the spirit as well as addressing the person’s physical and psychosociocultural needs. This descriptive, qualitative study, believed to be the first of its kind conducted in a New Zealand setting, focuses on spirituality issues of a spiritually vulnerable group of people, older people in residential care. From this group of people I recruited four Rest Home residents who were prepared to talk to me about their spirituality, spiritual needs and how their spirits were nurtured, the role of care staff in providing spiritual care, and their satisfaction with the spiritual care they were being offered. They were also asked to predict their spiritual needs as they were dying, their wishes for spiritual care in the perideath period, whether they had communicated these wishes to anyone, their views on advance planning to ensure these wishes would be met, and their comfort with the research process. The research data was collected from semi-structured, audiotaped interviews that were later transcribed.
The spirituality of all participants had a strongly Christian focus that was revealed in the ten themes to emerge from a modified application of Colaizzi’s analysis technique. The first themes to emerge were God as the focus of spirituality, God in control, the importance of relationship, and the purpose in life: serving God. Changes in spirituality with age, spirituality and residential care, and spiritual care: whose responsibility? were also identified as themes, as were end of life spirituality, planning for spiritual care, and the participants’ satisfaction with the research process. All were able to articulate their spirituality, were generally satisfied with the spiritual care they were receiving, and had views on the spiritual care they wished to receive in the perideath period. Moreover, the participants trusted their families and the care staff to ensure that these wishes would be honoured.Recommendations are made for improving the spiritual dimension of care, and for further research. Similar research, for example, should be carried out in different residential care settings, especially in the “for profit” sector. Research should also be undertaken to gauge the awareness care staff have of residents’ wishes for spiritual care in the perideath period.